Potential side effects from medications used to treat Fibromyalgia
• All SNRIs may increase risk for suicidal ideation upon initiation.
• Many of the drugs (SNRIs, SSRIs, tramadol, others) can increase the chance of developing serotonin syndrome when used together or at high doses. Pregabalin and gabapentin do not increase this risk. Potential drug interactions need to be checked and the patient monitored. Patients who develop hyperreflexia on these medications are most at risk.
• SNRIs, milnacipran: nausea, vomiting which are lessened by giving it with food. Insomnia, dizziness, high BP, and liver and renal dysfunction can occur.
• Pregabalin, gabapentin, TCAs: fatigue, somnolence, dizziness, weight gain, dry mouth, hyponatremia (TCAs).
• Tramadol: fatigue, somnolence, dizziness, nausea, headache, high BP, and liver and renal dysfunction.